FORM 1023-EZ for MEDICAL SOCIETY OF EASTERN PENNSYLVANIA

Field Data
EIN 23-3001864
Case Number EO-2016305-000141
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEDICAL SOCIETY OF EASTERN PENNSYLVANIA
Organization’s Mailing Address PO BOX 8664
City PHILADELPHIA
State PA
ZIP 19104
Accounting period End 6
Primary contact name ROBERT CLARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALISON ALEXANDER
PRESIDENT
4168 GERMANTOWN AVENUE
PHILADELPHIA PA 19140

Officer/Director/Trustee Two

DERIC SAVIOR
VICE PRESIDENT
3401 NORTH BROAD STREET
PHILADELPHIA PA 19140

Officer/Director/Trustee Three

SAFFIYA SHABAZZ
FINANCIAL SECRETARY
1335 WEST TABOR ROAD STE 204
PHILADELPHIA PA 19141

Officer/Director/Trustee Four

ROBERT CLARK
TREASURER
2265 GEORGES LANE
PHILADELPHIA PA 19131

Organization’s website NMAMSEP.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/20/1999
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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